Would you know if your child was depressed or suicidal?

With the WHO report showing that number of suicides rose by 58 per cent between years 2008 and 2017 and rapidly rising, it is a major cause for concern to parents when those incidences include teenagers. Psychotherapist Chris Hart shares with Sunday Magazine some of the signs that your child needs help.
Do you get the impression that there’s more depression and suicide among children these days, especially teenagers? It’s true, there is. All around the world surveys report a growing sense of despair among young people, and rising numbers of suicides.

Because it’s not only adults who get depressed. So do children and teenagers. Unfortunately, childhood depression, especially in teens, can be difficult to spot. Because all kids get low or moody from time to time. But childhood depression’s different from those ‘normal’ blues. It’s not a passing mood, and it won’t go away without help. 

So consider the possibility of depression if one of your children is sad for more than a few weeks, or is often down. Watch especially for low mood, unhappiness, tearfulness or irritability that doesn’t seem to be related to something sad that has happened recently. For example it’s perfectly normal for your child to be upset if a family member has died. But think about depression if their reaction seems excessive, or goes on far too long. Or if there’s increasing social isolation, or signs that their mood is affecting their day-to-day activities at home or school, or they’ve lost interest in things that they used to enjoy.

Think about depression if you notice or your child talks about:

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·         Frequent or prolonged sadness or crying

·         Mood changes 

·         Low self-esteem 

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·         Feelings of hopelessness, worthlessness or guilt

·         Fatigue or low energy

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·         Difficulty concentrating

·         Aches and pains with no obvious physical cause

·         Irritability or anger

·         Withdrawal from friends and activities at home

·         Changes in eating habits

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·         Increased sensitivity to rejection

·         Gets into trouble at school or reduced grades

·         Refuses to go to school 

·         Self-harming or thoughts of death, despair or suicide

Depression and anxiety often occur together, so you might also see restlessness, agitation, or a struggle to sleep or eat. They might even talk about experiencing very real psychotic symptoms, like paranoia or hearing voices, but that’s rare.

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Depression runs in families, and it’s also often triggered by events such as divorce, bereavement, house moves or health problems. It can also be a side effect of a medicine - check the list of side effects on the patient information leaflet. Depression affects both boys and girls, but girls are more likely to become depressed during adolescence, especially by online or physical bullying or peer pressures.

Why are depression and anxiety rates rising among children? 

The answer’s not straightforward, and even the experts are divided. Politicians and celebrities also like to have their say, so there are a wide range of opinions, based as much on political philosophy as on psychology. 

So one group argues that depression and anxiety rates are rising because life is more stressful now for young people, because of parental poverty, broken homes and single parent families, competition for college places, and the fear that they’ll be unable to find work or housing.

Another group focuses on increased bullying, especially online and in the social media, particularly with respect to gender roles, body image and ideals of shape, weight, beauty and so on.

Yet another group suggests that modern parents are over-protective, leading to ‘snowflake’ children who lack resilience in the face of life’s pressures.

Probably there’s some truth in all of these viewpoints. And good evidence - as opposed to opinion - that children and teens are more socially isolated than their predecessors, and that reduced face to face social interactions lead to greater levels of depression.

Suicide attempts rare in under-12

Depressed children may attempt suicide, though it’s rare under-12. Girls make more attempts, but boys are more likely to succeed. Children with a family history of alcohol abuse, and violence, physical or sexual abuse are at greatest risk. Most suicides are impulsive. Studies of people who came close to dying from suicide attempts show that almost three-quarters went from deciding to kill themselves to making an attempt in less than an hour.

Warning signs of suicidal behaviour in children:

·         Many clear symptoms of depression 

·         Increased crying or reduced emotional expression

·         Increased undesirable behaviours

·         Increased risk-taking behaviours

·         Frequent accidents

·         Substance abuse 

·         Social isolation, including from their family

·         Focuses on morbid or negative topics

·         Talks about suicide, hopelessness or helplessness 

·         Talks about death and dying

·         Is giving away possessions

What can you do when you notice worrying signs?

 If you’re worried that one of your children might be suffering from depression, start by just talking to them. Try saying something like ‘You don’t seem your usual self, is there’s anything I can help with?’ And whatever they tell you, don’t trivialise it. It may not sound a big deal to you, but children see the world differently to adults. 

Teens especially are more likely to open up if you show them that you respect their intelligence, and aren’t judgmental about anything they say.

If they mention specific problems, encourage them to think of ways they might solve the problem, rather than making suggestions of your own. ‘So when you feel like that, is there anything you can do to make yourself feel better?’

If they get angry, try not to react. Kids often hit out at the people they most love and trust, not because they hate you, but because they feel confused.

You’ll find out more if you ask open questions, and avoid asking questions they won’t answer. For example, if you suspect your child has an eating disorder, asking questions like ‘What did you have for lunch?’ is too confrontational, and invites a dishonest answer.

Sticking to open questions such as ‘How are you?’ or ‘How’s your day been?’ helps your child talk to you about how they’re actually feeling.

Children also often worry that telling an adult will just make things worse. So make it clear that you only want to help, and won’t do anything they don’t want you to.

If you’re still worried after talking to your teen, take them to see their doctor to ensure there are no physical reasons for their symptoms. If nothing physical’s found, arrange a session with a psychologist who specialises in young people. Diagnosis can be difficult, because very few depressed children will have all of the symptoms, and most will show different symptoms at different times and places. The symptoms of childhood depression also overlap with normal emotional and psychological changes in growing children. And so many children with depression or anxiety will be incorrectly diagnosed.

Which means that prevention is by far the best treatment. That’s mostly about being involved in your children’s lives, being supportive, and helping them learn to cope well with real life problems. Especially try to reduce the time your teens spend on their smartphones, and ensure they’re well connected to other teens and to your family. Because teens suffer less depression if they spend more time in face to face social interactions, sports and exercise, attending religious services and reading actual books and magazines.

Above all, children and young people need to feel respected, loved, and unconditionally valued for who they are. Whatever they are. Do that, and you’ll go a long way towards protecting your children against depression.

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